Usman Hamid – As Indonesia's Covid-19 case count continues to climb past one million, the government's disregard of other public health measures in favour of an aggressive mandatory vaccination drive shows a clear neglect of its human rights obligations.
President Joko "Jokowi" Widodo was the first Indonesian to receive a Covid-19 vaccination on 13 January, live on national television. The government portrayed the moment as a turning point in the fight against Covid-19 but the public's response has been less enthusiastic.
The Chinese-manufactured Sinovac vaccine – the only one currently available in the country – has been met with considerable scepticism. Efficacy data has varied widely, with results from the largest clinical trial in Brazil finding that although it was effective in preventing serious disease, it was only 50.65% effective in preventing infections. This rate is well below that of alternative vaccines now being distributed in other countries.
Experts have also raised concerns about the limited safety and testing information disclosed about the Chinese vaccines. Scepticism among the public has been further amplified by widespread misinformation being shared on social media.
Distrust of Covid-19 vaccines is apparently so rampant that on 9 February, Jokowi issued a presidential regulation stating that anyone who refuses vaccination could be denied social assistance or government services, or even face a fine. Following up on the regulation, last week the Jakarta government said it would fine residents up to Rp 5 million (US$355) if they refused vaccination. This would be a heavy fine for the millions of poor in the nation's capital.
Amnesty International has said that a blanket mandate on vaccination, especially one that includes criminal penalties, is a clear violation of human rights. Covid-19 vaccines should only be administered with the free, prior, and informed consent of the person concerned.
International human rights instruments allow for restrictions on human rights for public health ends, but only if certain safeguards are included. Covid-19 immunisation plans must be carried out in a way that is consistent with the protection of human rights. Rather than issuing a mandate that carries criminal penalties, actively engaging with the public and examining why scepticism remains prevalent would be a more humane – and more effective – strategy to protect public health.
Government officials have argued that a blanket mandate on vaccinations is necessary to protect the public's right to health by reducing Covid-19 transmission. This is highly ironic, as the government has shown a clear disregard for the public's right to health throughout the pandemic.
Elderly Indonesians will now be targeted as the second phase of the vaccination program is rolled out. But the government's initial focus on "productive-age" workers over the most vulnerable elderly populations suggests that its top priority is still economic growth, rather than public health.
The government's lack of seriousness in protecting the public's right to health can also be seen in how it has all but given up on proven public health measures that have been effective in other countries, such as creating a robust and reliable contact tracing system and encouraging social distancing and mask-wearing.
Covid-19 task force spokesperson Wiku Adisasmito has recognised that contact tracing in the country has fallen far short of the task force's own target of 30 close contacts identified for every person who tests positive. In Jakarta, which has the strongest contact tracing system in the country, the ratio is only eight contacts for every confirmed case.
Meanwhile, one of the people the government has relied on to spruik the vaccine, presenter and social media influencer Raffi Ahmad (who has a combined 69 million followers on Instagram and YouTube), was recorded attending a party without wearing a mask or practicing social distancing, just hours after he received the vaccine.
If Indonesia decides to move forward with a blanket mandate, the country will stand out in the region for its heavy-handed approach to mass immunisation. Indonesia's close neighbours, such as Malaysia, Singapore and the Philippines, have said that Covid-19 vaccinations will not be mandatory.
Indonesia doesn't need to be the odd one out and should invest its resources in ensuring access to objective scientific information, in relevant languages and in accessible formats for all people. As World Health Organisation experts have said in regard to mandatory vaccinations, "we are much better served to present people with the data and the benefits and let people make up their own minds".
Mandatory vaccination is particularly concerning given that Indonesia has a history of using coercive tactics for the sake of public health. During the authoritarian New Order period, heavy-handed social and administrative pressure was used to pressure women to take up the government's family planning program in certain areas of the country.
Opposing mandatory vaccination is not the same as opposing vaccination altogether. Widespread community vaccination will be essential if Indonesia is to overcome the Covid-19 disaster.
But Indonesia's Covid-19 response in general, and its vaccination efforts in particular, would be better served by enacting common-sense public health measures rooted in human rights, while disseminating credible and accurate information around Covid-19 vaccines, rather than relying on the fear of criminal penalties.